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Organization
SALT LAKE DONATED DENTAL SERVICES
Active
Organization
SALT LAKE DONATED DENTAL SERVICES
Active
Other names
SLDDS
Organization subpart
No
Provider details
NPI number
Authorized official
MS. STEPHANIE M. JENSEN (EXECUTIVE DIRECTOR)
(801) 983-0351
Entity
Organization
Contact information
Practice address
1383 S 900 W, SUITE 128, SALT LAKE CITY, UT 84104-1603
(801) 983-0350
(801) 983-0353
Mailing address
1383 S 900 W, SUITE 128, SALT LAKE CITY, UT 84104-1603
(801) 983-0350
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
870422710002
—
UT
Enumeration date
01/13/2009
Last updated
01/16/2009
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